Difference Between a Graft and Plug?

[HappyMan2021]

I'm confused on the difference between a graft and a plug. Even when I look at pictures of "plugs" I'm not exactly sure what makes them pluggy. 

I'm getting a repair with one of the top repair docs in the world and have been told badly angled or otherwise sh*t grafts can be 'redirected' in 1 round of surgery, whereas plugs is the more arduous journey of extraction and multiple procedures.  

When I examine my hair in the mirror, what are tell-tale signs the hair is a 'plug' vs a normal graft?

 

Edited February 23, 2022 by SadMan2021

[1978matt]

Plugs used to use a 4mm diameter punch to cut out a circular disc of skin/hair from the back of the head.  Each disc had maybe 25 hairs in total.  These were then implanted by cutting out a similarly sized hole in the recipient area and replacing it with the plug.  Hair direction was limited by the angle the 25 hairs exited the donor area.  All the doctor could do is position the disc in one particular direction, eg with all the hairs pointing forward, at an angle etc.

Grafts to me would be anything between say 1-8 hairs within it - 2 to 3 FUs.  They used to use the terms Micro (1-2 hairs) and Mini Grafts (3-8 hairs) back in the day.  Anything larger is falling into plug territory.

[HappyMan2021]

21 minutes ago, 1978matt said:

Each disc had maybe 25 hairs in total

very interesting. So a true tell tale sign of a classic plus is a bunch of hairs clumped together for a single incision/hole? 

I definitely have bad grafts (badly angled and non blended), but do not have clumps of hair per incision, so doesn't seem like I have plugs at least.  

[DrMunibAhmad]

A pluggy hairline looks pluggy due to to big grafts in the hairline. Most of the times these are multigrafts, but even thick singles can make a hairline pluggy. Furthermore a more vertical angulation of these grafts can cause the hairline to look even more pluggy. 

 

[HappyMan2021]

26 minutes ago, DrMunibAhmad said:

A pluggy hairline looks pluggy due to to big grafts in the hairline. Most of the times these are multigrafts, but even thick singles can make a hairline pluggy. Furthermore a more vertical angulation of these grafts can cause the hairline to look even more pluggy. 

Hi @DrMunibAhmad so grafts can definitely look "pluggy", but a true 'plug implant' in the surgical sense is an incision that has dozen(s) of hairs for one hole?

[BDK081522]

Yes, true plugs were what surgeons were doing in the 80's and 90's because that's all the technology and instrumentation could offer. Strip surgery came next with dissection into follicular units and FUE is the newest method of extraction. The term pluggy hairline usually isn't actually referring to the old "plugs". It's referring to multi unit grafts or coarse singles with bad angles in the front of the hairline thereby making it look unnatural. 

[Gatsby]

A true 'punch graft plug' back in the day when I had them was performed with a 4mm biopsy punch! As has been said the could only be positioned so that they all were planted so that the hairs contained were positioned in a similar direction (which was not always the case). The sad thing is that the surgeons back then never took into account the future progression of MPB. If they did they probably would never have performed punch grafting because the end result was a bald head covered with scars and punch grafts popping up everywhere. They were much more destructive of the scalp donor than FUE and FUT. This was in the era of hair transplantation's infancy.

[AA1989]

I think nowdays it's considered a pejorative term but back in the 1950's it was probably cutting edge. The term graft is as much to do with distancing themselves from the past. In essence the process has just become more refined & reliable (in skilled hands) allowing for single hairs rather than clumps of hairs to be transplanted.

[Rahal Hair Transplant]

HeySadman,

When people use the word “Plug”, they are typically referring to the old-school larger graft that contains anywhere between four to even 12 or more hairs.   These are classified by using different names depending on how many hairs are in each graft.  A follicular unit is a smaller craft containing 1 to 4 hairs which is how they grow naturally in the scalp.

I hope this helps 

Rahal Hair Transplant

Edited February 24, 2022 by Rahal Hair Transplant